1. Field of the Invention
This invention relates to catheters, for instance for use in cystoscopy and in ureteroscopy, and more particularly to ureteral and urethral catheter devices which can be inserted into a part of a patient through endoscopic instruments for various catheterization purposes, for example during cystoscopic and ureteroscopic procedures.
2. Prior Art And Other Considerations
In general, catheterization procedures utilize endoscopes, cystoscopes, or ureteroscopes provided with at least one passage for insertion of a catheter therethrough. These endoscopic instruments may be of a rigid or flexible type and comprise optical paths for illuminating and viewing of target regions. The passage for insertion of a catheter is provided with an entry in a so-called endoscope bridge arrangement often having coupling and sealing means disposed in this entry. Generally, a catheter is inserted by manipulative threading of the catheter into the entry and through the catheter passage of the particular endoscopic instrument to the target area. Delicate manipulative maneuvering and guidance is required to safely and accurately extend and position the catheter tip to the required target area, for instance to a ureteral orifice and into a ureter. Customarily, catheters for such purposes comprise a laterally flexible, but inextensible tubular structure, often having a tip shaped to suit various purposes.
A difficulty associated with the threading and manipulative maneuvering of conventional catheters through endoscopic instruments to particular target regions is caused by the need to simultaneously hold and guide the endoscopic instrument, to view the region through an ocular, to perform various adjustments and to operate endoscope controls, as well as to handle the catheter and attachments associated therewith. Moreover, spillage of bodily fluids is often rather difficult to avoid with conventional catheter arrangements. Not only is considerable skill required, but the procedure sorely taxes the manipulative capability of the urologist's hands to perform a plurality of control tasks more or less simultaneously. Additionally, the length of ureteral catheters, commonly about twenty six inches and longer, provides for cumbersome storage and handling in deployment, particularly due to the need for maintaining the catheter under aseptic conditions.
Catheters of various kinds have been in use for about a century and, in combination with endoscopes, are now routinely employed, particularly also in urological diagnostic procedures. Catheters which originally used slender tubes of metal have evolved into tubes of rubber and plastic in a great variety of shapes and sizes adapted to different specialty tasks.
For instance, U.S. Pat. No. 2,009,825 issued to Wappler discloses an aseptic catheter-handling device relating particularly to the sterile manipulation of catheters. Wappler shows a catheter-grasping member carried at the forward end of a flexible tube that accommodates the longitudinally movable catheter therein and that is adapted to releasably engage the forwardly projecting portion of the catheter.
Another catheter device disclosed by Bonner, Jr., in U.S. Pat. No. 3,894,540 comprises an elongated flexible conduit including a protective sheath in form of telescoping tubing or in accordion-pleated tubular form.
Arblaster discloses in U.S. Pat. No. 3,606,889 a guard accessory for catheters which includes a tubular housing provided with shallow corrugations to facilitate axial expansion and contraction.
Mori et al discloses in U.S. Pat. No. 3,886,933 a ureteral catheter device insertable through a cystoscope.
U.S. Pat. No. 4,568,334 issued to Lynn discloses an intravascular catheter container assembly including a pleated glove which surrounds a portion of the catheter. U.S. Pat. No. s 4,062,363 issued to Bonner and U.S. Pat. No. 4,327,735 issued to Hampson also show pleated catheter guards.
Frisbie discloses in U.S. Pat. No. 4,569,347 a catheter-introducing device having a Luer fitting, and Hauser discloses in U.S. Pat. No. 4,168,699 a catheter having an inner tube with a loop used to hold the tube in a retracted position.
The expandable catheter and bridge device of the present invention is intended to overcome the difficulties of the prior art, particularly in respect to improving ease of handleability during endoscopic procedures, to reduce occurrences of spillage of body fluids, and to significantly reduce pre-packaged catheter lengths and free lengths to be manipulated during deployment.
Accordingly, an overall feature of the invention is the provision of a catheter device comprising a laterally flexible tubular structure including a longitudinally expandable section. A further feature includes a rigid bridge-like handle structure for attachment to an endoscope, to facilitate expanding the expandable section, and to facilitate catheter maneuvering and manipulation during endoscopic procedures while reducing incidence of fluid spillage. The structure also permits significantly reduced pre-packaged catheter lengths and free catheter lengths to be aseptically manipulated and deployed in use.